Individual
MR. MICHAEL R MEDVED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3560 A1A S, SAINT AUGUSTINE, FL 32080-9731
(904) 584-2273
(904) 823-9394
Mailing address
3560 A1A S, SAINT AUGUSTINE, FL 32080-9731
(904) 584-2273
(904) 429-9783
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3163
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA3163
MEDICAL LICENSE
FL
Enumeration date
03/26/2007
Last updated
12/13/2023
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